Medical Forum / General / Dentistry / August 2005
University Pays Dental Students to Stay Away
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Flap - 28 Aug 2005 00:22 GMT This is kind of humorous but perhaps some of the U.K. dentist contributors can weigh in here.
What is going on in Scotland?
At my blog: http://flapsblog.com/?p=834
And a direct link to the Scotsman: http://news.scotsman.com/index.cfm?id=1844702005
Flap
http://flapsblog.com
Joel344 - 28 Aug 2005 00:52 GMT Thanks Flap .... interesting story!
A SCOTTISH university is paying dental students £2,000 to delay their training, despite the country’s chronic shortage of NHS dentists.
 Signature Joel344
letsconnect - 28 Aug 2005 01:04 GMT > This is kind of humorous but perhaps some of the U.K. dentist > contributors can weigh in here. [quoted text clipped - 5 lines] > And a direct link to the Scotsman: > http://news.scotsman.com/index.cfm?id=1844702005 I'll try and find out, but first things first: how much would it cost to do a dental degree in the US (tuition fees)?
Joel344 - 28 Aug 2005 01:20 GMT Nice banner too!
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[image: http://img173.imageshack.us/img173/9647/univdundee5hi.jpg]
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-- Joel34
Flap - 28 Aug 2005 01:37 GMT Your Post:
Flap wrote:
> This is kind of humorous but perhaps some of the U.K. dentist > contributors can weigh in here.
> What is going on in Scotland?
> At my blog: http://flapsblog.com/?p=834
> And a direct link to the Scotsman: > http://news.scotsman.com/index .cfm?id=1844702005 I'll try and find out, but first things first: how much would it cost to do a dental degree in the US (tuition fees)?
Flap's Reply:
Here is a link to all of the dental schools in the USA and Canada (separate link): http://www.ada.org/prof/ed/programs/search_ddsdmd_us.asp
It varies whether the school is private or state supported.
Flap
http://flapsblog.com
letsconnect - 28 Aug 2005 02:04 GMT Flap Wrote:
> Flap wrote > Here is a link to all of the dental schools in the USA and Canad > (separate link) > http://www.ada.org/prof/ed/programs/search_ddsdmd_us.as > > It varies whether the school is private or state supported. A ballpark figure will do
-- letsconnec
Flap - 28 Aug 2005 02:45 GMT Your post:
Flap Wrote:
> Here is a link to all of the dental schools in the USA and Canada > (separate link): > http://www.ada.org/prof/ed/pro grams/search_ddsdmd_us.asp
> It varies whether the school is private or state supported. A ballpark figure will do.
-- letsconnect
Flap's Reply:
Well, the link is the best resource since each state university or private university has their own fee make-up. Some states charge very little but subsidize their tuition and fees for state residents in the hope they will stay at home and practice there after graduation.
Living expenses vary by geographic region of the USA. New York = high, Oklahoma = low.
Thus, ball park figures will vary quite a bit.
Financial aid is readily available at low interest rates for tuition, fees and living expenses.
LetsConnect where do you live? Are you from the USA or Canada?
Flap
http://flapblog.com
letsconnect - 28 Aug 2005 03:38 GMT I fail to see the connection between "socialized" dental healthcare and shortage of university places? Maybe you could open up a private dental school in Scotland and see if you get enough takers :-) (business idea). Although usually, the students at private medical schools in Europe/UK tend to come from the US and Asia (cos the fees tend to be rather high).
Flap - 28 Aug 2005 03:56 GMT Your Post:
I fail to see the connection between "socialized" dental healthcare and shortage of university places? Maybe you could open up a private dental school in Scotland and see if you get enough takers :-) (business idea). Although usually, the students at private medical schools in Europe/UK tend to come from the US and Asia (cos the fees tend to be rather high).
Flap's Reply:
The government heavily subsidizes dental education in the U.K.through taxation and plans dental education through a central government model.
When the dental student graduates the U.K government also provides heavily subsidized dentistry through their National Health Service and provides financial incentives for the new graduates to become NHS dentists. Apparently, the government cannot pay enough since a good number of dentists are or have quit the NHS.
In other words their national government through a socialized model (heavy taxation and subsidization) affects the number and distribution of dental practitioners, goods and services throughout the country. As a result of their action, instead of a free market model like in the United States and Canada (for dentistry only) you see shortages, waiting lists, dislocations, craziness (like the subsidy of dental students not to study) and rationing of care.
A free market private dental school in a government controlled economy. Hardly think it would be profitable.
With regards to the last comment, I would suspect that a good number of dentists and physicians come to the United States to work to get away from the painfully high taxation that their government's impose to fund their social democratic redistribution schemes.
Flap
http://flapsblog.com
letsconnect - 28 Aug 2005 04:04 GMT 120-odd students accepted at Dundee - we don't know how many of them were accepted by another university as well and take up that place instead. So it's by no means certain that the course is as heavily oversubscribed as it might appear at first glance. It's a news story, for God's sake. Is the NHS really so much worse than medicaid and DHMOs (which are pretty useless if someone needs extensive treatment)? I'm not that keen on the NHS, but feel these "socialized dentistry" rants are getting out of control.
Flap - 28 Aug 2005 04:16 GMT Your comment:
120-odd students accepted at Dundee - we don't know how many of them were accepted by another university as well and take up that place instead. So it's by no means certain that the course is as heavily oversubscribed as it might appear at first glance. It's a news story, for God's sake. Is the NHS really so much worse than medicaid and DHMOs (which are pretty useless if someone needs extensive treatment)? I'm not that keen on the NHS, but feel these "socialized dentistry" rants are getting out of control.
My original post:
This is kind of humorous but perhaps some of the U.K. dentist contributors can weigh in here.
What is going on in Scotland?
At my blog: http://flapsblog.com/?p=834
And a direct link to the Scotsman: http://news.scotsman.com/index .cfm?id=1844702005
Flap
http://flapsblog.com
Flap's Reply:
Yes, the NHS is really worse than medicaid and DHMO's. Ask the U.K dentists who are talking with their feet and either leaving the U.K and coming here or are dropping out of the NHS and going private. And ask the U.K patients that que up hundreds to a lined to get on a NHS subscriber list.
Letsconnect, you are not a dentist.
I do not believe you live in the USA. In fact, when I asked you where you were from you ignored the question.
I live and have practiced dentistry in the USA for over 27 years. I know the state of dentistry here and in the U.K..
My original post was not a rant and if you consider it so then I am sorry.
Now, are there any dentists or folks from the U.K. that care to weigh in here?
Sheesh.
Flap
http://flapsblog.com
George Chatzipetros - 28 Aug 2005 13:30 GMT My 2p on this, since this was recently discussed among my british colleagues:
The government decided to increase training positions in the various dental schools across the UK because of the shortage of dentists. However, it did not provide the funds for the additional positions. Hence, Dundee offers incentives for students to stay away because they know they will exceed their current capacity to teach them. Add a constantly declining number of academic dental professionals and you'll have a recipe for disaster: poorly trained students entering the real world to experiment on patients.
The NHS is certainly worse than medicaid and DMOs. It's not only that the fees are lower, but the whole system is very intrusive in your practice. You don't have the obligation to offer treatment to medicaid or DMO patients, but if you hold a NHS contract number you are obliged to provide ALL treatment necessary to your NHS patients as well as be burdened by all the insane bureaucracy, rules and regulations accompanying it. The appallingly low quality standards of british dentistry can be traced back to the NHS institution, which held a monopoly on treatment up until 10-15 years ago. Other areas of NHS treatment also suffer equally or more than dentistry; people die everyday in NHS hospitals from MRSA, patients have to wait up to 18 months for surgery, and you can't expect your GP to spend more than 5 minutes to examine you.
About "socialised dentistry": A fully private system would exclude a lot of people on low incomes and create social inequalities and dissent. A fully nationalised system has historically led to depressed fees, rationing of services, poor quality standards and the abusement of healthcare professionals. There has to be a balance between the two. A safety net that can provide treatment to those unable to afford it and a private system for the rest.
George
Joel344 - 28 Aug 2005 13:40 GMT At my dental school, they did not have to pay us to stay away. We stayed away on our own. First of all there were the 8:00am lectures ..... we stayed away from those big time ......
Joel
 Signature Joel344
letsconnect - 28 Aug 2005 14:41 GMT I would agree that the NHS system leaves (non-salaried) NHS dentists i the UK worse off than their counterparts in the US. However, I'm stil convinced that the UK system provides superior access to dental car for those who are on limited incomes and don't qualify for medicai (quite a substantial number of people). The situation may be differen in California, I don't know
In any event, apparently the spend on private dentistry in the UK i now greater than the NHS spend, so one would have to be hard-pushed t describe it as a "socialized" system. The truth is somewhere i between
George Chatzipetros Wrote:
> My 2p on this, since this was recently discussed among my britis > colleagues [quoted text clipped - 33 lines] > > Georg -- letsconnec
George Chatzipetros - 28 Aug 2005 15:18 GMT Believe me I do understand what you're saying, but I want to point out a few things:
First of all, I don't see the reason why an entire class of professionals should suffer by seeing 40 patients a day or go bankrupt just because the government wants to boast that it can support viablke, cheap dentistry. It may be cheap, but it's certainly not viable and last time I checked I wasn't living in the Soviet Union.
Second, with the current shortage of NHS dentists many people on low incomes will have NO access to a dentist, let alone a private one.
Third, maybe those people on low income would have the money for access to dentistry if they didn't have to dole out an 8% supertax just for their health coverage AND pay for dentistry on top of that.
And lastly, if in general the british people got decent dentistry instead of cheap McFillings that need to be replaced after a year, maybe they wouldn't need dentists that much in the first place!
Most of UK dentistry is still delivered in the NHS, but private spend seems bigger because private fees are much higher than the ridiculously low NHS fees.
letsconnect - 28 Aug 2005 15:33 GMT George, I know what you're saying, and do agree with you (I would alway advise people in the UK to avail of private treatment if they can at al afford it). To get some idea of what I'm talking about regarding th situation in some US states, have a look at this
http://www.dentistry.com/cgi-bin/ubb/forumdisplay.cgi?action=topics&forum=Studen ts+|AMP|+Dental+Schools&number=16&DaysPrune=45&LastLogin
I've made the same observation on our message board - NHS dentistr isn't great by any means, but what gets me about Flap's blog is th sneering attitude towards dentistry in other countries, when things ar by no means perfect back home..
George Chatzipetros Wrote:
> Believe me I do understand what you're saying, but I want to point ou > a few things [quoted text clipped - 22 lines] > ridiculousl > low NHS fees -- letsconnec
Flap - 28 Aug 2005 20:09 GMT George's Post:
Believe me I do understand what you're saying, but I want to point out a few things:
First of all, I don't see the reason why an entire class of professionals should suffer by seeing 40 patients a day or go bankrupt just because the government wants to boast that it can support viablke, cheap dentistry. It may be cheap, but it's certainly not viable and last time I checked I wasn't living in the Soviet Union.
Second, with the current shortage of NHS dentists many people on low incomes will have NO access to a dentist, let alone a private one.
Third, maybe those people on low income would have the money for access to dentistry if they didn't have to dole out an 8% supertax just for their health coverage AND pay for dentistry on top of that.
And lastly, if in general the british people got decent dentistry instead of cheap McFillings that need to be replaced after a year, maybe they wouldn't need dentists that much in the first place!
Most of UK dentistry is still delivered in the NHS, but private spend seems bigger because private fees are much higher than the ridiculously low NHS fees.
Flap's Reply:
George, how can a new graduate make it in the U.K?
Do they have to indenture themselves with the NHS?
And who pays for the subsidized tuition to your dental schools? Are there any truely private dental schools in the U.K.?
Flap
http://flapsblog.com
Flap - 28 Aug 2005 20:06 GMT Let'sConnect's Post:
I would agree that the NHS system leaves (non-salaried) NHS dentists in the UK worse off than their counterparts in the US. However, I'm still convinced that the UK system provides superior access to dental care for those who are on limited incomes and don't qualify for medicaid (quite a substantial number of people). The situation may be different in California, I don't know.
In any event, apparently the spend on private dentistry in the UK is now greater than the NHS spend, so one would have to be hard-pushed to describe it as a "socialized" system. The truth is somewhere in between.
Flap's Reply:
Letsconnect, I would suggest you go over to the BBC and read about the problems with the NHS Dentistry in the U.K.
Here is a link for you:http://newssearch.bbc.co.uk/cgi-bin/search/results.pl?scope=newsifs&tab=news&q=N HS+dentistry&go.x=21&go.y=15&go=go
Since you do not live or practice in the USA (you are not a dentist) I would suspect you know little about USA dentistry except what you read from people posting on the internet.
I live it every day and have for the past 27 years.
So, any questions?
Flap
http://flapsblog.com
W_B - 29 Aug 2005 17:43 GMT >However, I'm still >convinced that the UK system provides superior access to dental care >for those who are on limited incomes and don't qualify for medicaid >(quite a substantial number of people). This just an utopian pipe dream.
The facts do not bear out your conclusion. --
W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com
Flap - 28 Aug 2005 19:58 GMT George's Post:
My 2p on this, since this was recently discussed among my british colleagues:
The government decided to increase training positions in the various dental schools across the UK because of the shortage of dentists. However, it did not provide the funds for the additional positions. Hence, Dundee offers incentives for students to stay away because they know they will exceed their current capacity to teach them. Add a constantly declining number of academic dental professionals and you'll have a recipe for disaster: poorly trained students entering the real world to experiment on patients.
The NHS is certainly worse than medicaid and DMOs. It's not only that the fees are lower, but the whole system is very intrusive in your practice. You don't have the obligation to offer treatment to medicaid or DMO patients, but if you hold a NHS contract number you are obliged to provide ALL treatment necessary to your NHS patients as well as be burdened by all the insane bureaucracy, rules and regulations accompanying it. The appallingly low quality standards of british dentistry can be traced back to the NHS institution, which held a monopoly on treatment up until 10-15 years ago. Other areas of NHS treatment also suffer equally or more than dentistry; people die everyday in NHS hospitals from MRSA, patients have to wait up to 18 months for surgery, and you can't expect your GP to spend more than 5 minutes to examine you.
About "socialised dentistry": A fully private system would exclude a lot of people on low incomes and create social inequalities and dissent. A fully nationalised system has historically led to depressed fees, rationing of services, poor quality standards and the abusement of healthcare professionals. There has to be a balance between the two. A safety net that can provide treatment to those unable to afford it and a private system for the rest.
Flap's Reply:
Good to hear your 2p or two cents on these issues.
What do you forsee as a solution to the NHS problem in the U.K?
What is the British Dental Association doing? The Labor government?
Flap
http://flapsblog.com
George Chatzipetros - 28 Aug 2005 22:02 GMT The British Dental Association is a very poor excuse of a trade union. Last year it was "discovered" it had a very large deficit which almost pointed to fraud. This should give you a very good idea of how it is actually run. A lot of dentists have abandoned it in the past few years. As for the government, well its problem is that it consists of politicians = the scum of the earth. We have the conservatives, who cannot be trusted with anything because they're frankly morons, and the labour, who cannot be trusted with anything becausde they're spinsters and liars of the worst kind. So basically we're screwed.
My solution to the NHS problem? I don't know for sure. We are in Europe and we cannot just abandon a largely social health model as it has been part of our culture for very long. But the NHS model is clearly not working, it's not even "free" anymore as the labour likes to boast. We've got to have a balance between private and social provision of health, and for that we might want to look at countries like France or Sweden who manage to have good state-funded services with a very different approach. The time of freebies is long past.
All I know is that for a person on average income, which is about 20K per year if I'm not wrong, national insurance contributions at 8% will come at 133 pounds a month. This entitles you to the very poor service the NHS offers as well as a state pension that is so low you can't even pay for cigarettes. But this amount of money would be enough to get both BUPA private medical and Denplan private dental care and you would have some change to put in youir private pension care. The reason private care seems so expensive for some poeple is that you have to pay for the state services even if you don't actually use them. Where does all the money from our taxes go? Everywhere but to the people who can actually help (doctors, nurses, dentists etc). It goes to failed asylum seekers from kosovo, 12-year old mothers, people who spent years on the dole and other freeloaders, NHS managers and administrators, a 30 billion pound IT system that will probably be outdated by the time it's finished and a 80K sculpture of a rock to be placed outside UCL hospital. Can you say "your tax pounds at work"? I am working in a deprived area and I see a lot of people on "benefits". You won't believe the amount of freeloaders and parasites I have encountered in my short time here.
George
Flap - 29 Aug 2005 06:43 GMT George's Post:
The British Dental Association is a very poor excuse of a trade union. Last year it was "discovered" it had a very large deficit which almost pointed to fraud. This should give you a very good idea of how it is actually run. A lot of dentists have abandoned it in the past few years. As for the government, well its problem is that it consists of politicians = the scum of the earth. We have the conservatives, who cannot be trusted with anything because they're frankly morons, and the labour, who cannot be trusted with anything becausde they're spinsters and liars of the worst kind. So basically we're screwed.
My solution to the NHS problem? I don't know for sure. We are in Europe and we cannot just abandon a largely social health model as it has been part of our culture for very long. But the NHS model is clearly not working, it's not even "free" anymore as the labour likes to boast. We've got to have a balance between private and social provision of health, and for that we might want to look at countries like France or Sweden who manage to have good state-funded services with a very different approach. The time of freebies is long past.
All I know is that for a person on average income, which is about 20K per year if I'm not wrong, national insurance contributions at 8% will come at 133 pounds a month. This entitles you to the very poor service the NHS offers as well as a state pension that is so low you can't even pay for cigarettes. But this amount of money would be enough to get both BUPA private medical and Denplan private dental care and you would have some change to put in youir private pension care. The reason private care seems so expensive for some poeple is that you have to pay for the state services even if you don't actually use them. Where does all the money from our taxes go? Everywhere but to the people who can actually help (doctors, nurses, dentists etc). It goes to failed asylum seekers from kosovo, 12-year old mothers, people who spent years on the dole and other freeloaders, NHS managers and administrators, a 30 billion pound IT system that will probably be outdated by the time it's finished and a 80K sculpture of a rock to be placed outside UCL hospital. Can you say "your tax pounds at work"? I am working in a deprived area and I see a lot of people on "benefits". You won't believe the amount of freeloaders and parasites I have encountered in my short time here.
George
Flap's Reply:
Just got into Laughlin, Nevada from a long and hot drive. Thus, the delay to reply.
Damn, George it is worse than what is in the BBC and other press reports.
Since Blair is on his way out is there any incentive for your government to reform your system or will the free market be allowed to work? Or will the government rein it in?
How much does your dental education cost? Is tuition and fees not subsidized but the student is responsible for their own living expenses while in school?
Perhaps we should look at the Swedish model but the American one with less taxation and more individual incentive with more population may be an alternative with a few British innovations.
I, too, wonder about the mothers of children presenting for their state (Medic-Cal) paid fillings wearing designer sunglasses and driving fancy SUV's(Sports Utility Vehicles). I see this often.
More later.... off to the poker tables.
Flap
http://flapsblog.com
George Chatzipetros - 29 Aug 2005 09:57 GMT Flap, I'm not from the UK, I only came here two years ago, so I can draw some comparisons. National healthcare in the UK is a big joke. If someone told my folks back home that you can only see your doctor for 5 mins and you have to wait 18 months for a hip operation, people would burn down the parliament and diesmbowel the politicians. But here it is considered the norm, because after 50 years of state monopoly people don't know that there can be better things.
There are going to be reforms... the wrong reforms. Next April there is going to be a new "deal" coming out. It's one of these "take it or leave it" deals. Basically, it says instead of paying you per procedure we will give you whatever you earned last year and we expect you to see 5% more patients. Also, you'll have to see every emergency sent to you by them, even if that will put one of your regular patients at a disadvantage later on. Wonderful stuff.
What does dental education cost here? As I said I'm not from here, but I have heard that most students graduate with debts of 30K pounds, which is not terribly bad I suppose. Interestingly, in my home country (Greece), my education cost me NOTHING and after I graduated I had to pay back NOTHING as well. And the people there didn't expect me to go into indentured service or something - they saw that as an investment for the improvement of the country.
George
W_B - 29 Aug 2005 17:02 GMT >Flap Wrote: >> [quoted text clipped - 6 lines] > >A ballpark figure will do. How about the SuperDome ? --
W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com
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